Abdominal Gossypiboma Presenting as Probable Acute Appedicitis: A Case Report

Textiloma or gossypiboma is a term used to describe a mass formed by surgical textiles left inside a patient following a surgical procedure and the and the surrounding foreign body reaction. Its incidence has decreased considerably; however, its high legal and social impact has prompted its review. The clinical presentation is varied and nonspecific; the location, time of evolution, and type of inflammatory response affect a wide spectrum of clinical scenarios, from an incidental finding in imaging studies to a serious condition secondary to complications (abscesses, intestinal obstruction, sepsis, among others). In this context, imaging support is essential. Plain radiography is usually the initial approach due to its easy access and interpretation, but the radiopaque marker can disintegrate or become distorted over time. Computed tomography allows for greater diagnostic sensitivity, but it can easily be misinterpreted as a neoplasm, abscess, or hematoma if the distinguishing characteristics are unknown. The presence of a hypodense spongiform mass with bubbles inside and a wall that enhances with contrast, or a reticular mass surrounded by a calcified crust, should guide diagnosis. Textilomas are ultimately complex problems, not only from a legal and social perspective but also from a medical perspective, with imaging studies and a history of surgical procedure being the keys to a timely diagnosis.